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Toxic relationships come in all types— romantic partners, business partners, parents, siblings, friends…
and everyone, at some point in their lives, has experienced a toxic relationship.
As a therapist you’ll encounter at least one client a month who is preparing to leave or has left a toxic relationship. They’re emotionally fragile, so being well-educated on how to provide the best care for your client is a must - as well as how to deal with your own feelings of frustration when your client returns to the toxic relationship.
Stephanie Sarkis PhD is the author of the best-selling books Gaslighting: Recognize Manipulative and Emotionally Abusive People— and Break Free and Toxic Relationships: Help Your Clients Recover from Gaslighting, Narcissism, and Emotional Abuse.
Watch Dr. Sarkis, for this training where she shows you, through evidence-based practice: trauma-informed therapy, dialectical behavior therapy, solution-focused therapy, acceptance and commitment therapy, cognitive-behavioral therapy, case studies and her 20 years of experience, how to help clients rebuild their lives after the trauma of a toxic relationship:
Knowing what to do when your client gets “hooked” on the cycle of abuse & reconciliation
Client who continues to seek out similar toxic relationships
Moving on without closure
Letting go of anger and self-blame
Establishing boundaries
Practicing self-care
Grief – working through the loss
Rebuilding emotionally healthy relationships
Don’t miss out on getting answers to an all-too common but underdiscussed personality type!
Purchase today!
Credit
Planning Committee Disclosure - No relevant relationships
All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners. For speaker disclosures, please see the faculty biography.
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Stephanie Moulton Sarkis, PhD, NCC, DCMHS, LMHC, is a psychotherapist specializing in anxiety, gaslighting, narcissistic abuse, and ADHD. She is the author of eight books and two workbooks, including Healing from Toxic Relationships and Gaslighting. Dr. Sarkis is a national certified counselor, licensed mental health counselor, American Mental Health Counselors Association Diplomate (clinical mental health specialist in child and adolescent counseling), and Florida Supreme Court Certified Family and Circuit Mediator. She has been in private practice for over 20 years. Dr. Sarkis is also a senior contributor for Forbes online and a contributor to Psychology Today. She hosts the Talking Brains podcast and is based in Tampa, Florida. Visit her at www.stephaniesarkis.com.
Speaker Disclosures:
Financial: Dr. Stephanie Moulton Sarkis maintains a private practice. She serves as a contributor to Forbes, The Huffington Post, and Psychology Today and is an advisory panel member for Evergreen Certifications. Dr. Sarkis is a facilitator for Collaborative Divorce. She receives royalties as a published author. She receives a speaking honorarium, recording, and book royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Stephanie Moulton Sarkis is a professional expert for Understood.org, part of the National Center for Learning Disabilities. She is a member of the Attention Deficit Disorder Association, American Mental Health Counselors Association, Children and Adults with Attention Deficit Disorder, and the National Board for Certified Counselors.
Employ evidence-based practice from trauma-informed therapy, dialectical behavior therapy, solution-focused therapy, acceptance and commitment therapy, and cognitive-behavioral therapy to assist clients in rebuilding their lives.
Assess suicidality effectively and treat it through integrative psychodynamic psychotherapy and dialectical behavior therapy.
Determine a diagnosis of complex PTSD through trauma-informed interviewing skills.
Evaluate the research-based benefits of altruism through volunteering in increasing self-esteem and self-efficacy.
Analyze how parental alienation further traumatizes clients and their children.
Build 10 tools to help clients reestablish healthy boundaries via research-based activities.
Utilize clinical strategies to uncover and heal client’s family-of-origin trauma.
Minimize symptoms of post-traumatic stress disorder through trauma-informed therapeutic techniques.
Prescribe individualized therapeutic care to improve client engagement when discussing experience of abuse.
Determine level of family-of-origin pathology in order to inform choice of treatment interventions.
Demonstrate knowledge of vicarious trauma for purposes of reducing clinician burnout.
Diagnose complex post-traumatic stress disorder in a clinical setting.
Outline
Neurochemical Cycle of Abuse: Every Day is a Recovery
Harder to leave when trauma bonding has occurred
Abuse = cortisol levels and adrenaline increases
Reconciliation = dopamine and oxytocin increase
Client’s brain can get addicted to this cycle
Withdrawal and/or reframing grief after the relationship (i.e., drug withdrawal)
Phases of Toxic Relationships – Cycle of Abuse
Attachment Style – Predictor of abuse vulnerability
Idealizing - Relationship begins - seems too good to be true, pressured commitment
Devaluing - Toxic person starts emotional abuse, eventually ramps up into physical abuse
Discarding - Client discovers toxic person’s infidelity, “financial cheating” or toxic person leaves
Results of Toxic Relationships
Complicated grief
Questioning what was “real” in the Relationship
Complex PTSD
Dissociative episodes
Brief psychotic episode
Dissociative identity disorder
Suicidality
Case study: Sarah, a 52-year-old female who is experiencing complex grief as a result of an abusive family of origin and abusive relationship
Returning to the Toxic Relationship
Leave toxic relationships at least three times before they leave for good or are killed
Abusers “hoover” victims to get their “narcissistic supply”
Therapists may start “fixing” rather than supporting client – codependent behavior
Solution-Focused Therapy to Relearn Self-Care
Creating future plans
Emotional and physical safety
ADL’s – in extreme cases
Reconnecting with healthcare (infidelity, etc)
Seeking injunction – restraining order
Reframing self-care as a necessity rather than a luxury
Case study: James, a 53-year-old male relearning basic life skills that were lost as a result of severe abuse and depression
Trauma-Informed Therapy to Break Free from Codependence
Multicultural therapy’s view that codependence is a culture-bound term
Multi-cultural implication – divorce, religious, traditional gender roles/abuse
Determining clients “secondary gain” from codependent behavior
Toxic Family of Origin
Abuse can be intergenerational
Family of origin substance abuse
“Splitting” - golden child and a scapegoat child
Siblings may maintain dysfunctional roles into adulthood
Using genograms to identify client’s familial behavior patterns
Transgenerational family therapy
Caregiving and elderly toxic parents
Existential Therapy Tools to Manage Suicidality
Best way to assess for suicidality according to research
Myths about suicidal behavior
Hidden signs of suicidality
Evidence-based treatment of suicidality resulting from abuse
Case study: Emma, a 17-year-old who has ended an abusive relationship
Coparenting with a Toxic Personality
Parental alienation
Using detailed parenting plan
Resources available - parent coordinator, family law attorney (some do pro bono work)
Communicate via a coparenting app
Case study: Ian, a 48-year-old who is learning how to coparent with their ex-partner who has been diagnosed with narcissistic personality disorder.
DBT & Grief Therapy Techniques to Redefine Closure
Toxic person will not give closure
Toxic people keep exes and friends “in rotation”
Helping clients find their own closure
Forgiveness is not necessary for closure
Dangers of pushing an agenda of forgiveness on clients
Sometimes closure is not possible
Clients can have fulfilling lives without closure or forgiveness
Reconnecting with Trusted Friends and Family
Reassessing emotional health of client’s loved ones
Client’s level of disclosure about the abuse to friends and family – how much is too much
Case study: Jimmy, a 28-year-old male reconnecting with family after going no-contact with his mother
ACT & Trauma-Focused Techniques to Help Client Forgive Themselves
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